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Volume 6, Issue 2

Adalene Lynch & Dr. Donald Cinotti

Tina Cressman, CPC

Drs. S. Manzoor Abidi & Niranjan “Bonki” Rao Joe Piscopo

(L-R) Sharon Ruth, Joan Ledzian


Congratulations!

Peter W. Carmel, MD On Being Elected

President of the

American Medical Association

The Medical Society of New Jersey Proudly Recognizes This Great Honor and Extends Its Best Wishes

Physician Advocate (ISSN 1555-5054) is published quarterly (winter, spring, fall, summer) by the Medical Society of New Jersey (MSNJ), 2 Princess Road, Lawrenceville, NJ 08648. Free to MSNJ Members. Periodicals postage paid at Trenton, NJ, and at additional mailing offices. POSTMASTER: send address changes to Physician Advocate, 2 Princess Road, Lawrenceville, NJ 08648


“NoNewTaxes…” Michael T. Kornett

H

Chief Executive Officer

—GubernatorialCandidate ChrisChristie

ow’s this for a conundrum? While our President and national legislature took up healthcare reform on the idea to expand affordability, NJ’s Governor and our state legislature set about to tax healthcare into submission.

That’s right. The bi-partisan budget accord reached in late June increased the potential tax liability on physician-owned surgical clinics from $200,000 to over $350,000 per facility annually. This poor state health policy proposed by our governor, and agreed to by our elected legislature reduces access to care by making many free standing, privately owned healthcare centers no longer financially viable businesses. How many businesses saw their potential tax liability increase by 30 percent in this budget? ◆ Not the health insurance companies with their multi-millionaire Chief Executives. ◆ Not the hospitals, that cry poverty while finding a way to pay their chief executives handsome compensation packages. ◆ Not Big Pharma or the medical device manufacturers our governor went after as the US Attorney. No, the governor had all those choices available and he decided to raise taxes on physician-owned small businesses; businesses that provide jobs, pay corporate real estate and sales taxes and contribute to the economy even in these hard times. Physician-owned and directed diagnostic and surgical clinics provide efficient healthcare services in communities around the state.

It is difficult to reconcile the state’s expansion of the tax on healthcare services with the federal policy of expanding health insurance. More individuals will seek more services as they become insured under the new federal reforms. However, New Jersey anti-physician tax policy will drive more physicians from private ventures and reduce the number of facilities available to provide care to the expanding number of people seeking healthcare. The result…a long wait for necessary care. The last candidate campaigning to become governor (then-governor Jon S. Corzine) came to the Medical Society of New Jersey’s annual meeting and pledged support for the physicians of our state. Déjà vu, the new governor did the exact same thing on a pre-election visit, attesting to the need and his support to keep and recruit the finest and brightest doctors to practice in New Jersey. We are indeed sensitive to the priorities that face our new governor, but neither he nor the lieutenant governor would accept an invitation to our three-day annual meeting. It would appear that Christie’s remarks of being a one-term governor would be acceptable to him since he is alienating an integral population to the health and well-being of New Jersey’s citizens. A bright side…while taxing medicine is wrong and we are strongly opposed to this corporate tax, we do see an opportunity for the governor to prove to the physicians in NJ that he recognizes their value in the Garden State. Currently, there are two bills pending in the Senate and Assembly respectively which would create meaningful tort reform in the state. The governor should express that physician malpractice exposure has to be modified to keep his campaign promises and urge the legislature to get those bills on his desk for signing as soon as possible – Governor, it’s hard for the medical community to remain silent on this issue. My hopes are that after his next visit to his own physician, he’ll understand the importance MSNJ’s physicians are in New Jersey. I don’t know of too many politicians in New Jersey experienced in administering a colonoscopy. Michael T. Kornett Chief Executive Officer

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Inaugural Message from MSNJ President, Donald J. Cinotti, MD

Thank you all for the opportunity to serve as the 218th president of the Medical Society of New Jersey. It is an honor and a privilege to represent the oldest medical society in the United States.

“...adversity gives us challenges and leads to opportunity.”

I am deeply honored, but I’m reminded of what Oscar Wilde wrote: “In this life there are two great tragedies. The first is not getting what you want. The second is getting what you want.” So be careful what you wish for you might be MSNJ President one day! Rather than talk about personal tragedy, I would like to focus on the theme: adversity gives us challenges and leads to opportunity. We all know that the practice of medicine today involves great challenge and adversity. Indeed, in no other time in history have physicians been faced with so many changes in the practice of medicine. But as Francis Bacon—a man of science—said: “Prosperity best discovers vice, but adversity best discovers virtue.” I believe that these times of adversity present us as an organization and a profession with the chance to reaffirm our commitment to our patients and bring positive change to healthcare in our state and nation. This year, my goal as president of the MSNJ is to move us toward meeting these challenges and bring about this change. In my view, the three most important challenges to the medical profession have not changed. They are: — Government intrusion in the practices in medicine — Detrimental insurance company practices — Tort reform We are looking ahead to having to deal with additional government regulations and intrusion in the care of our patients. For example, the new Patient Protection Act, recently signed into law, will be going into effect over the next four years. Physicians are having difficulty planning for the future since many of the regulations have yet to be written. Congress still has not fixed the SGR problem. This year we will be challenged in our State with bills limiting out of network charges. In addition specialty board recertification may become the method for renewing your state license. Our membership’s major concern is the one-sided insurance contracts which they feel forced to sign. We also know that insurance companies and soon Medicare will be rating physicians on the delivery of quality of care. This has the potential danger of becoming economic credentialing. We have not forgotten about tort reform. The new patient protection act does not solve our malpractice problem but it does, however, offer opportunities for pilot projects which we may find helpful in New Jersey. I have told you what I think are the three most important challenges before us, and now I’d like to discuss my proposals to address these challenges. In order to stop government intrusion we need to influence the people making the laws. If you don’t like the laws, change the lawmakers. How do we do this? To meet the challenge in dealing with state and national governments we must increase our PAC contributions. Your Political Action Committee, under the leadership of Dr. John Poole, has been doing a tremendous job. Think of how much more effective they would be if they had more money to use. It is our responsibility to make these contributions and to become more politically active. We can also be effective by identifying the candidates who best represent our interests. We need to convince more physicians to run for political office. In 2006 there were 22 physicians running for Congress. In 2008 there were 30 and now in 2010 there are 47 physicians running for Congress. Let’s extend the physicians interest to the state legislature. Another challenge is the change in employment status of physicians. More and more physicians are seeking employment by hospitals or large group practices instead of branching out on their own into private practice. Many of them believe that their employers should pay for their membership in professional organizations.

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Our challenge is to find services that they are willing to pay for themselves. Our opportunity is to have a class of membership by group or hospital. The face of medicine is changing. The entering classes in medical school are now more than 50% women. Soon the percentage of physicians entering practice will be predominantly female. Our challenge is to provide services that this group will find beneficial. In two years we will have a female president, Dr. Mary Campagnolo, and president-elect, Dr. Ruth Schulze. Here is an opportunity for us to help prepare the medical society to change the diversity in membership. I look forward to working with the two of you and the leadership of MSNJ to meet this goal. While we are speaking about diversity in membership let’s address the lack of young physicians in our society. We have done very well with medical students because we invite them to give their ideas and to get involved, but we lose them during their residency. Our challenge will be to meet with senior residents and determine what services they require when entering into the real world of medicine. We have the opportunity for MSNJ to work with President William Owen, MD of UMDNJ to encourage faculty and resident involvement in the society. There is a new emphasis on payment for quality of care and the monitoring mechanism will be in electronic health records. Initially Medicare bonuses will be paid to physicians for implementation of this technology. Later, penalties will be instituted for not having EHR. The cost of EHR is not only the start-up expense of hardware and software, but the maintenance and upgrades in these systems will be prohibitive for single practitioner offices to obtain this technology. In a recent study, practices with fewer than three doctors show that only 4% have EHR. In the largest practices, more than 51% have implemented EHR. Our opportunity, is for MSNJ to make sure that our physicians are prepared to receive those bonuses and this technology. I envision the merger of smaller practices and creation of large care centers. Under the national health care reform there will be demonstration projects on delivery of care organizations. There will be a demand for physicians with health care policy and business training. We have established a partnership with Seton Hall University for physicians to obtain a Master’s Degree in Healthcare Administration at a discount tuition fee via the internet. MSNJ has put major emphasis on the business of medicine and the education of physicians and their staff. Today, the MSNJ Medical Practice Management Section boasts more than 500 members and the quality of programming of the Practice Managers Section were put on display during this year’s Annual Meeting. If you haven’t attended a MSNJ educational session, I encourage you to do so and bring a friend. I’m confident that you will learn something new. We continue to face apathy among physicians in New Jersey. We need to help them change this attitude. When groups of physicians are together we hear nothing but complaining of the adversities they face in practicing medicine. Our challenge is to convince them that working together within MSNJ is the best solution to their problems. The opportunity is to give them a place to bring their grievances and to give them a sense that we are all in this together. We have heard physician’s protests that the AMA and MSNJ do not represent their ideals. No institution has ever been changed by burning it to the ground. If we don’t like the direction which the Medical Society of New Jersey or the American Medical Association are taking we are not going to change it by quitting. The only way to effect change is motivating like-minded individuals to join the societies, move up into leadership and transform their policies. We will continue to be one of the most proactive state medical societies in the AMA. Your delegation has never been shy in voicing your opinions in the AMA House of Delegates; and this will continue. We are the family of medicine. MSNJ has twenty-one component county societies. Many of our counties are doing excellent work in providing services for our membership. Some counties are failing to provide any service. Our challenge is to merge the staffing of the weaker counties with their stronger neighbors. These combined groups should provide an economy of scale and professional management. This should give us

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“For the next year, my focus as your president is to overcome the adversity and rise to the challenges by creating opportunity within MSNJ.”

the ability to send staff to recruit new members at hospital meetings and any gathering of physicians. We will also continue having the counties President’s conference before the Board of Trustees meetings to share ideas and collaborate on county and state initiatives. We also need to strengthen the coalition with the state specialty societies. We all have a common goal of protecting New Jersey physicians and the right to care for their patients. Working together we can take advantage of a larger voice in Trenton. I will re-start the specialty society Presidents meetings to encourage closer cooperation. We cannot allow medicine to be splintered. We will continue to work with the State Government to make New Jersey a desirable place to practice medicine and to stop new physicians from fleeing the state. For the next year, my focus as your president is to overcome the adversity and rise to the challenges by creating opportunity within MSNJ. I envision a more streamlined Society that will continue to strive for high-quality services while keeping the cost of membership affordable. We have begun this year, under the leadership of Dr. Joe Reichman, to prepare our society to use the new technologies in communication of the 21st century. You can appreciate the changes in this meeting by the implementation of the online reference committees. This has saved the Medical Society thousands of your membership dollars and your valuable time. Our hope is that this new way of doing business will attract the new members. As you know, the policies of MSNJ are determined by you, the House of Delegates, and the Board of Trustees. The President carries out policy and acts as your spokesperson. Over the next year we will have ample opportunity to further our goals as a society by meeting with members of the state legislature, state regulatory agencies, and the insurance industry. I promise to you that we will continue to defend the ability for New Jersey physicians to give the best care to our patients. We must never forget that we are a profession that gives service, and this is a service organization. For many years I have worked with a charity organization, “Healing the Children” NJ, where I have attended workshops in how to raise money and promote volunteerism. All of these courses start out with, the ten most important two letter words in the English language, “If it is to be, it is up to me.” As your president for the next year, I will take it upon myself to make a difference in the Medical Society of New Jersey. I ask all of you to take that same perspective and have an impact on your patients, your profession, and your Medical Society. I am looking forward to working with our wonderful, competent and hard-working staff under the leadership of our Chief Executive Officer, Michael Kornett. I want to thank Dr. Joe Reichman and Dr. Raj Gupta for their mentorship in the last two years and all the previous presidents for their leadership and guidance. I want to thank all of you for continuing your membership and involvement in making the process of this medical society what it is today. I also want to thank you for putting your faith in me and giving me the honor to be your spokesperson for the next year.

Donald J. Cinotti, MD President Medical Society of New Jersey 4


Donald J. Cinotti, MD 218th President Medical Society of New Jersey Dr. Donald James Cinotti is a board-certified Ophthalmologist who has practiced medicine in New Jersey for close to 30 years. He was born, raised and lives in New Jersey. Don entered medicine due to the influence of his parents. His father, Dr. Alphonse Cinotti, a pioneer in New Jersey Ophthalmology, was the first Chairman of the Department of Ophthalmology at Seton Hall College of Medicine, which later became the University of Medicine and Dentistry of New Jersey (UMDNJ). His mother, Kathleen, is a registered nurse who trained at Kings County Medical Center in New York. Don graduated from Wabash College in 1972, and then attended medical school at the Autonomous University of Guadalajara, Mexico. He completed his internship in Internal Medicine at St. Michael’s Hospital in Newark and Holy Name Hospital in Teaneck. He did his residency in Ophthalmology at New York Eye & Ear Infirmary. Following completion of his residency in 1981, Don joined his father and Dr. Barrry Malzmann at Hudson Eye Physicians and Surgeons (HEPS) in Jersey City. After 29 years with HEPS, he continues to take care of patients and perform surgery with his partners Dr. William Constad and Dr. Joanna Pruzon. Don is a Clinical Associate Professor of Ophthalmology at UMDNJ, supervises residents at Jersey City Medical Center, and regularly lectures on advocacy to Ophthalmology residents and state ophthalmological societies around the country. Don has long been committed to serving the community and the profession. While in medical school, he helped run a clinic in the poor section of Guadalajara. In 1988, he became involved with Healing the Children, a nonprofit organization dedicated to providing medical services to children around the world. During his association with Healing the Children, Don has performed cataract and glaucoma surgery on children from Central and Latin America, as well as on children whom the organization has brought to the United States for care. He has been trip chief on numerous medical missions to the Dominican Republic, Ecuador, Honduras, and Mexico. For the past two years, Don has served as Chairman of the Board of the Mid Atlantic Chapter of Healing the Children. In honor of his volunteer efforts, NJ Biz magazine recently awarded Don the 2010 Nonprofit Innovation Award for Board Member Excellence. Don has also been active throughout his career in medical and specialty societies. He began his work with the Medical Society of New Jersey (MSNJ) in 1985 as Chairman of the MSNJ Young Physicians Section and delegate to the Young Physicians Section of the American Medical Association (AMA). He has held many leadership positions in the MSNJ, including member of the Board of Trustees, Chairman of the MSNJ Scope of Practice Coalition, and delegate to the AMA. He currently serves as Associate Secretary and Chair of the Congressional Advocacy Committee of the American Academy of Ophthalmology (AAO), and as a member of the Executive Committees of the New Jersey Academy of Ophthalmology and the Hudson County Medical Society. He formerly was President of the Hudson County Medical Society, President of the New Jersey Academy of Ophthalmology, Chairman of the AAO State Affairs Committee, and Counselor from New Jersey to the AAO. Don has been married to his patient and understanding wife, Paulette, for 35 years. They have three sons: David, an attorney, who is married to Kathleen Grant; Daniel, a candidate for a Ph.D. in Counselor Education, who will marry Michelle Velasquez in July; and Matthew, a student at the Institute of Culinary Education in New York. Don’s children are as proud of their father’s accomplishments as Don is of them.

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Lastmonthatthe2010 AmericanMedicalAssociation HouseofDelegates,Medical SocietyofNewJerseymember andpediatricneurosurgeon, Dr.PeterCarmelwasselected asPresident-Elect.Hewilltake thereinsaspresidentofthe nation’slargestphysician organizationinJune2011. Carmelbecomesonlythe secondphysicianfrom NewJerseytoleadthe 163-yearoldAMA.*

MSNJ MEMBER SELECTED AS PRESIDENT-ELECT OF THE AMERICAN MEDICAL ASSOCIATION

Dr.Carmelcurrentlyservesas ChairmanoftheDepartment ofNeurologicalSurgeryatthe UniversityofMedicineand DentistryofNewJersey(UMDNJ), aProfessorofSurgeryatthe NewJerseyMedicalSchool andCo-MedicalDirectorofthe NeurologicalInstituteofNew JerseyinNewark.

AccordingtotheAMA,hewas firstelectedtotheAMABoard ofTrusteesin2002,andre-elected in2006.AmemberoftheAMA TheChicago Tribune reported HouseofDelegatesfor17years, Peter Carmel waves to the AMA House of Delegates thatCarmelwasinararethree- Dr.after Dr.Carmelservedaschairofthe receiving the news that he has been elected by doctorraceforpresident-elect his peers to become AMA president for 2011-2012. SpecialtyandServiceSocietyand andhebeatouttwomembers helpeditachieveAMAbylaws ofthe21-memberAMAboardoftrusteesthatare recognition.WhileservingaschairoftheAMACouncilon primarycaredoctors:aMassachusetts obstetrician LongRangePlanningandDevelopment,thecouncilorigiandanIndianafamilydoctor. natedtheAMAInternationalMedicalGraduatesSectionand establishedproportional “Iamhonoredtobeelectedtoleadthenation’smost representationforspecialty influentialphysicians’organization,”saidDr.Carmel.“As medicalsocietymembers. AMApresident-elect,Ipledgetoserveasastrongvoice From2006to2007,Dr. anddedicatedadvocateforpatientsandphysicians onthe Carmelservedaspresident pressingissuesconfrontingourhealthcaresystem.” oftheAMAFoundationand “HispeersintheHouseofDelegatesgotitrightwhen currentlysitsonitsboard theyvotedforDr.PeterCarmeltobecomethenext ofdirectors. presidentoftheAmericanMedical MSNJalsorecognizesDr.Carmelasa Association,”statedDr.DonaldCinotti, GoldenMeritawardrecipient.Theaward th MSNJ’s218 president.“Wehavethe honorsphysicianswhograduatedfrom utmostconfidence inhisabilitiesto medicalschool50yearsago.Hereceivedhis representphysicians andpatientsnotonly BachelorsofArtsdegreefromtheCollege inhishomestateofNewJersey,butthe oftheUniversityofChicagoin1956,anM.D. UnitedStates.Hehasourfullsupport.” degreefromNewYorkUniversity,Bellevue Carmelhaspromisedthatwhenhe CollegeofMedicine,NewYorkin1960, becomespresidenttheAMAwillbe andaDoctorofMedicalSciencedegreein moredemandingandaggressivewith neuroanatomyfromColumbiaUniversity, membersofCongressthanithasbeenin CollegeofPhysiciansandSurgeonsin1970. thepast.AccordingtotheChicago Tribune, MichaelT.Kornett,MSNJ’schiefexecutive CarmelsaidCongresscanexpectmore Dr. Carmel responds to a question during a three-person debate to officeradded,“Thereareveryfewpeople hard-hittingattacksfromtheAMAsuch become AMA president. whoknowthehealthcarereformlandscape astherecentfull-pageadvertisementsthe aswellasDr.Carmel.Ipredictthathewill doctorsgroupplacedinseveralnewspapersthatcriticized beefficientandeffectiveandhispresencewillbefeltin U.S.SenatorsforleavingWashingtonfortheirMemorial WashingtonDC.” Dayrecessbeforefixingthepaymentcut. “Theytellmethat(DemocraticSenateMajorityleader) HarryReidisinfuriatedwiththeadandIhopeso,” Carmelsaid.“IfIhadawayofinfuriatinghisRepublican counterpart(Senateminorityleader)MitchMcConnell, Iwoulddothat,too.” 6

*Dr.DavidB.Allman,AtlanticCity,wasthefirstAmerican MedicalAssociationpresidentfromNewJerseyin1957-1958


W

e would like to thank all of our sponsors and exhibitors for their unwavering support in our Annual Meeting activities. Without their contributions, this event would not have been possible.

MSNJ ANNUAL MEETING SPONSORS: UnitedHealthcare | NJ PURE | Willis of Delaware, Inc. | Mercedes Benz

MSNJ ANNUAL MEETING EXHIBITORS: AA – Alcoholics Anonymous AFLAC Alcon Laboratories, Inc. AllRisk American Express Athenahealth, Inc. Atlantic IT Bavelle Technologies Cape Professional Medical Billing David Lerner Associates, Inc. Expert Technology Associates FileBank, Inc. Flaster/Greenberg, PC

Health Care Billing, Inc. Link High Technologies MD On-Line MEDtalent, Inc. MSNJIA NaviNet Nixon Uniform & Medical Wear NJ PURE Professional Data Systems, Inc. QualCare Samaritan Hospice SRSsoft STI Computer Services, Inc. Verizon Wireless

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MSNJ honors those members who graduated with their medical degrees in the class of 1960. The class of 1960 will be recognized at a reception during the 2011 MSNJ Annual Meeting. ATLANTIC COUNTY George S. Groch, MD Edward L. Hoffman, MD Abram S. Kaplan, MD Gary H. Kelman, MD Hojabr F. Majlessi, MD Gastone A. Milano, MD Bernard Neff, MD BERGEN COUNTY Stephen M. Berque, MD Theodore Herbert Bodner, MD Arthur R. Desimone, MD Noel Friedland, MD Ramon M. Kasilag, MD Gerald M. Klein, MD Tien-Shun Li, MD Eduardo A. Liriano, MD Donald George Mc Kaba, MD Martin Schub, MD Eugene W. Sweeney, MD Donald H. Wolmer, MD BURLINGTON COUNTY Graham P. Jones, MD Charles J. Moloney, MD John R. Philson, MD Keith Joel Quinton, MD CAMDEN COUNTY Raymond E. Adams, MD Narni R. Giri, MD Gerald D. Grant, MD Kedar N. Kapoor, MD Koson Kuroda, MD Gerald Joseph Margolis, MD Vincent Thomas Mc Dermott, Jr., MD William P. Sims, MD CAPE MAY COUNTY Marvin S. Podolnick, MD

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ESSEX COUNTY Abraham Berman, MD Peter W. Carmel, MD I. Allen Chirls, MD Theodore A. Dacosta, MD Pande V. Josifovski, MD Jose Lavin, MD Ju-Cheng Lee, MD Giovanni Lima, MD Satish C. Madan, MD Virginia Ann Malfitan, MD Joseph M. Marchesano, MD Robert W. Morrison, MD Jesus S. Navarro, MD Dominick A. Rubino, MD GLOUCESTER COUNTY Edward B. Brown, MD Gerald Robert Keenan, MD Carl J. Minniti, Sr., MD Paul J. Schneider, MD HUDSON COUNTY Eugenia V. Crincoli, MD Luis Saturnino Fernandez, MD Alexander N. Kostek, MD Jose Ma S. Roldan, Jr., MD HUNTERDON COUNTY Glenn P. Lambert, MD Halsey K. Van Duyne, MD MERCER COUNTY Charles Akselrad, MD Jon E. Courtney, MD Joseph A. De Santis, MD Robert Fomalont, MD Fernando Hoyos, MD John F. Kustrup, Jr., MD Fraser Lewis, MD

MIDDLESEX COUNTY Harold Arlen, MD Stefan Ellis Epstein, MD Hans R. Gandhi, MD Jalaladdin Najafi, MD Virgilia G. Nebab, MD Bernard Pancer, MD Rebecca C. Rivera, MD MONMOUTH COUNTY Richard Johnston Brown, MD Regina M. Cuta, MD Anthony Raymond Garruto, MD Tania Jurtshuk, MD Lawrence Karasic, MD Carl M. Marchetti, MD Gregory Charles Moore, MD Rudolph Dominic Talarico, MD Samuel T. Westerman, MD MORRIS COUNTY Fred Benson, MD Fred Bigelsen, MD Arnold Buznitsky, MD Joel E. Cannilla, MD Louis P. Cardi, MD Carl Dubovy, MD Arthur T. Gionti, MD Harvey M. Hammer, MD Anibal J. Marulanda, MD Allan Walter Newcomb, MD Fred M. Palace, MD Ralph Reichert, MD Stephen W. Rozan, MD Robert Raymond Siroty, MD John G. Valeri, MD Ernesto M. Yap, MD Ralph Frederick Zito, MD

OCEAN COUNTY Mohammed M. El Kharboutly, MD Robert E. Fabricant, MD Pedro Q. Kiat, MD David A. Yazdan, MD PASSAIC COUNTY Harvey Cooper, MD Robert M. D'Andrea, MD Elliot M. Eisenstein, MD Melvin Julius Goldberg, MD Howard Bernard Kern, MD Mohammad A. Meah, MD Ravinder M. Narang, MD Allen Shalit, MD SOMERSET COUNTY Michael J. McCarthy, MD UNION COUNTY Pedro A. Beckford, MD Richard J. Bukosky, MD Charles Michael Culbert, MD Joseph A. Di Lallo, MD Ghitta Eibschutz, MD David Bruce Garmise, MD Stanley S. Marcus, MD Maurice S. Meyers, MD Mark Perrin, MD Melvin Rubenstein, MD Francisco A. Saavedra, MD Barry Schenk, MD Robert S. Shapiro, MD Raymond T. Snyder, MD William Nicholas Toth, MD Gizella S. Zoneraich, MD


VERIZON WIRELESS TEAMS UP WITH MSNJ TO EXAMINE USE OF WIRELESS DEVICES AND APPLICATIONS IN NJ’S MEDICAL PRACTICES This spring, the Medical Society of New Jersey and Verizon Wireless teamed up to poll members about the use of portable, wireless devices and how their usability applies to health information technology. The survey yielded some interesting results, highlighting that many MSNJ members currently utilize healthcare applications through mobile devices, smartphones, wireless PC cards and more. One hundred percent of respondents indicated that they do have wireless cell phone service this is a very positive finding. This demonstrates that MSNJ members have selectively adapted to the utilization of the technological advances created to make a more efficient and effective profession and society. When members were asked what wireless carrier they use, 83 percent of the respondents cited Verizon Wireless.* Service pricing and coverage as well as the proven track record were the main reasons that members selected a specific wireless service provider. An astounding 97 percent of the MSNJ members polled (physicians and practice managers) indicated that they use their phone for work/professional services. “We found this to be an amazing percentage for utilization,” said Michael T. Kornett, Chief Executive Officer, MSNJ. “Our hopes are that we can use this information to combine the wireless technologies with electronic health records in order to make all of our physicians in New Jersey more efficient in caring for their patients.” Eighty-six percent of the respondents felt that their knowledgebase was anywhere between ‘average’ and ‘tech savvy’ and more than 75 percent answered that they are currently using a Smartphone/PDA/Blackberry for professional purposes, with Blackberry as the preferred type. It is encouraging to see that the nearly 80 percent of the respondents use medical applications on their wireless devices.

Ninety-three percent responded that they use applications pertaining to drug and clinical references (i.e. epocrates) while more than 30 percent use their wireless devices for e-prescribing. “This is the trend in medicine and we need to adopt and implement the tools that are put in front of us,” said MSNJ President Dr. Donald Cinotti. “Verizon Wireless is a great MSNJ partner in that they are working closely with our physicians to help mould and shape the technologies that can benefit physicians across the United States.” While implementation and utilization of wireless device applications continue to grow, physicians still maintain that security is paramount. Ninety-seven percent responded that security is very important. Health Information Technology will continue to play a vital role in the practice of medicine as New Jersey and the rest of the country fully integrate technology into a profession largely dominated by charts, folders, papers and prescription pads. MSNJ and Verizon Wireless have teamed up to address the needs of physicians in New Jersey and explore opportunities to make wireless technologies as much a part of a healthcare provider’s everyday routine as the morning cup of coffee. Together, MSNJ and Verizon Wireless will be conducting a series of focus groups around the state to provide MSNJ members and healthcare providers the time and forum to sample some of the wireless devices and utilize their functionality. These focus groups will allow MSNJ members to provide input and feedback into what applications and devices physicians require to perform their duties and responsibilities to the best of their abilities. If you would like to participate in a MSNJ/VZW focus group please email dklim@msnj.org. Focus group date and times will be listed on the MSNJ website as they become available.

*It should be noted that only the last page of the survey indicated that this survey was done in conjunction with Verizon Wireless. This was done so that there was no bias in the selection process 9


MSNJ member and commissioner of NJ’s Department of Health & Senior Services, Poonam Alaigh, MD addresses the Society of the first time.

MSNJ Insurance Agency representative Kent Evans speaks with an attendee during the meeting.

First vice president Mary Campagnolo, MD takes a moment to send a symbolic message of optimism to all of New Jersey.

The 218th president of MSNJ, Donald J. Cinotti gives his incoming speech to the House of Delegates at the Annual Meeting.

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MSNJ members belt out a tune during the Jersey Shore-themed social event “Greetings from MSNJ.”

MSNJ chief executive officer, Michael T. Kornett speaks to the crowd during the practice management section of the meeting.

MSNJ’s past presidents welcome Joseph H. Reichman, MD to the club as he leaves the MSNJ presidency to become a distinguished fellow.

Former Saturday Night Live cast member Joe Piscopo and MSNJ fellow (and avid Bruce Springsteen fan) Dr. Rick Scott sing a duet to honor of the New Jersey rock and roll icon.

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Beginning January 1, 2011, MSNJ members will be entitled to a legal defense benefit included with membership. This valuable benefit is designed to provide you, our member, with high quality legal representation at the earliest stage of a legal action; the most critical stage when you are the target of an investigation. When a member is the subject of an investigation or disciplinary action, MSNJ will arrange for initial legal representation to file your response to disputes with the following entities: The NJ Attorney General’s Office The NJ State Board of Medical Examiners The Medical Practitioner Review Panel The NJ Office of the Insurance Fraud Prosecutor NJ State Medicaid Investigation Office of the Medicaid Inspector General The United States Attorney’s Office The Office of the Inspector General The Centers for Medicare and Medicaid Services Hospitals Nursing Homes Extended care facilities Ambulatory Surgery Centers The preliminary legal defense benefit is comprised of the following services: Initial interview Comprehensive legal review of the matter Initial written response to the entity bringing the dispute Preliminary appearance If the matter is not fully resolved or dismissed at the conclusion of the preliminary representation members have the option to retain their own counsel. MSNJ will not cover additional legal services under this benefit. MSNJ will arrange for discounted legal fees when possible.

If you are the subject of a complaint or an investigation call the Member Resource Center at 609.896.1766 or email info@msnj.org.

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ES! U D J N S M WIN FREE

Back by popular demand…

MSNJ Photo Contest Deadline: September 1, 2010 We are pleased to announce the opening of our Calendar 2011 Photo Contest for MSNJ members. Again this year, there will be twelve winners. The first-place winner will receive one year’s free MSNJ dues (the county dues will still have to be paid). The twelve winning photographs—only one per photographer—will be printed in the 2011 MSNJ Calendar, with the first-place winner appearing within the calendar and on its cover. Photographs should be of New Jersey places or things, not of people. Submissions should include the photographs’ titles and where they were taken. Please also include your full name, address, phone number, and preferred e-mail address. Because of the growing popularity of this contest photographers may submit no more than two photographs, no later than September 1, 2010. All entries should be e-mailed to photo@msnj.org. For questions contact the Member Resource Center at 609.896.1766 or email info@msnj.org. Once the judges have decided, the winning photographers will be asked to send high-resolution (300 DPI) copies of their winning photographs.

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QualCare Introduces New Workers’ Compensation Product Provides Cost Saving Options to Physicians in NJ & Health Care Related Companies

QualCare, Inc., in conjunction with the Affiliated Physicians MEWA (Multiple Employer Welfare Arrangement) Health Plan, a health plan sponsored by The Medical Society of New Jersey, has introduced an affordable Workers’ Compensation Product, QualComp, for physicians and health care related companies within the medical community. The introduction of this fully insured product is expected to save employers as much as 20% off their current premium charges. QualCare is dedicated to developing products that benefit the medical community and physicians as group employers. QualComp builds upon QualCare’s overwhelming success with the Affiliated Physicians MEWA Health Plan, which since 2002 has seen steady growth in enrollment and competitive rate increases. The Affiliated MEWA Health Plan, covering more than 6,500 lives, has had renewal increases averaging 10% or less over the past eight years and maintains a 97% renewal rate. QualComp is offered to current MEWA Health Plan members, New Jersey physicians and other healthcare providers.

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The benefits of the QualComp product are many, including: ® Up to 20% off Workers’ Compensation Premium Charges ® Highest Limits of Liability Available ® Long Term Plan to Provide Safety Programs ® Potential Dividend Payments ® Uses the QualCare network, so physicians refer to other physicians within the QualCare network The QualComp product is also administered with the same mindset as the Affiliated Physicians Health Plan. Not only does this Workers’ Compensation product utilize the QualCare Network, other services are handled by QualCare such as nurse case management and medical cost containment. In addition, Scibal Associates, a Subsidiary of QualCare Alliance Networks, Inc. provides adjusting services and program oversight. This coordination of services is key to maintain a successful program and keep claim costs down. “Physicians often overpay for Workers’ Compensation policies that only cover their employees,” said Annette Catino, President and CEO of QualCare. “Such a policy neglects themselves, their partners or shareholders and leaves physicians personally liable for their own medical bills. We are proud to be able to offer this product, which is designed specifically for New Jersey’s medical community.” Additional information on the QualComp or The Affiliated Physicians Health Plan product can be obtained by calling (888) 670-8135 or emailing mewasales@qualcareinc.com.

QualCare, Inc. is a full-service managed care organization that offers self-funded PPO, HMO Network, Point of Service (POS) Network, and Open Access Health Plans, third party administration (TPA) services, provider network access, utilization management services, and a Workers’Compensation product including medical case management, network access, TPA services and medical bill review and re-pricing. Headquartered in Piscataway, New Jersey, QualCare is owned by 12 non-profit hospitals and physician-hospital organizations. QualCare contracts with 100 acute, specialty and rehabilitation hospitals as well as over 20,000 physicians and other ancillary providers at 33,000 locations throughout New Jersey. Please visit us at www.qualcareinc.com.

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Better contracting

Larry Downs, Esq. | Arthur Timins, Esq.

Late in May, Horizon Blue Cross sent contract amendments to many physicians in New Jersey. MSNJ has received many calls for guidance as the amendments will become operative unless a physician opts to terminate their agreement with Horizon. Since MSNJ cannot provide individual legal advice to members, this article will review the key terms of any contract or contract amendment. Please consult with your own business or healthcare attorney for additional guidance or a legal opinion for your personal situation. A busy medical practice likely has many contracts with various health plans and may belong to several physician networks. All of these contracted arrangements can be distilled down to a simple proposition. The physician agrees to discount the fees charged for services in exchange for the health plan (or physician network) steering patients to the physician. This “discounted fee for patient steerage� is at the core of the bargain. However we all recognize that the participation agreement contains many additional terms and conditions that make the participating provider agreement much more complex. Some of the key parts of any contract will be discussed below.

Term and Termination The first questions doctors should ask is, “How long am I bound by this agreement and how can I end it if the relationship goes bad?" This clause of any agreement should state when the contract begins, when it ends, and what the obligations of the parties are upon separation. Some managed care contracts have very specific procedures for physicians wishing to end their contracts. Read the term and termination clause carefully to make sure you understand and agree with the obligations imposed upon you after termination. It is also important to understand how much you will be paid for your services after termination of the contract. Also you will need to understand fully what rights to information in your possession you have granted to the other party in the contract. You may be required to produce such information (at your cost) to the other party upon termination. In addition you may be required to provide notices to your patients. In some cases you may be required to allow the other party to the agreement access to your patients for the purpose of sending notices about your termination. You may, or may not have input into how the information is conveyed to your patients.

Fees The most important part of your analysis is to determine if the discounted fee is enough to support your practice overhead and costs of doing business with a margin leftover. It makes little sense to accept a fee that is below the cost of transacting the business. This evaluation of the value of the agreement should be contemplated regularly. Some contracts shift administrative burdens onto the practice. These burdens typically consist of complying with record production requests, pre-certifying certain procedures, and completing various forms and surveys which an insurance company or physician network may require from time to time. These administrative burdens should be considered when evaluating the value of a contract. Agreements should be re-evaluated annually or when amendments are made to determine if the agreement is still fair both in terms of reimbursement and administrative costs for the physician.

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Other Incorporated Documents When reading through an agreement check for the phrase, “these documents are incorporated by reference and are part of the agreement�. Any contract which incorporates other documents by reference and makes those documents a part of the contract should raise your concern. It is important to obtain those documents, review them, and understand what additional obligations (and the costs to comply) those documents create for the practice. In a managed care contract these other documents may be provider manuals or utilization review policies. In some agreements these documents may take the form of an extended warrantee (in the case of a lease on business equipment). Where these documents are incorporated by reference and become part of the agreement their terms have the same effect as a term written into the contract. Also be aware that when a party has the right to unilaterally amend those documents, you are agreeing to be bound by terms that are not yet known, but will be considered part of your agreement. Attention should be paid to whether the party must give individual notice of new policies or if the party has shifted the burden to the practice to monitor for new or changed policies.

Disputes Almost every agreement will have a clause that sets out the agreement of the parties to resolve disputes under the contract. The contract will state whether disputes are submitted to a mediator, arbitrator or a court of law. The parties will also typically choose the forum (state) and the law to be applied. These are important to review to decide how much money it will cost you to advance or defend a dispute under the agreement.

Rights and Obligations of Others Look at the obligations (or absence thereof) of the other contracting party or insurer. For example, if the contract imposes a burden on the physician to fill out forms, has the other party reasonably provided sufficient and up-to-date data to complete those forms? Also, does the proposed contract conflict in any way with a physician’s ethical obligation to provide the best possible care for his/her patient? In other words, do not evaluate any proposed contract in a vacuum.

Conclusion Whether you are considering a new piece of office equipment or whether or not to sign on with a new health plan, agreements layout the expectations of the parties for services to perform, payment for services rendered, and how the parties will relate to each other during the course of the agreement. The agreements govern most of the conduct of the parties while doing business together and thus are the first source to consult when disputes arise. It is important for physicians to obtain and update all of the agreements they entered into. Under the class action settlements agreed to by most major health insurers, copies of agreements are available to physicians upon request. Update your files to keep copies of all your agreements readily available. These documents will help you analyze each agreement for continued viability and assist you in understanding your rights should a dispute arise.

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Questions & Answers with NJ’s own

Joe Piscopo For the second straight year, New Jersey native and well-known entertainer Joe Piscopo sang karaoke with members at the 2010 MSNJ Annual Meeting. He also sat down with physician advocate and answered some questions for this edition of “MSNJ Spotlight”. PA So, now that you’ve sung karaoke with some of the best physicians New Jersey has to offer, what advice do you have for them? JP Have their people call my people. They’re my new opening act in Atlantic City! PA How’d you get your start as an entertainer? JP Comedy clubs in NYC. I think Truman was in office…!

JP

This question. Sorry, my 11 yr. old helped me on this one…(Joe Grano’s book, You Can’t Predict A Hero.)

PA What message do you have for the Medical Society of New Jersey physician-members and the patients they take care of? JP Keep your wonderful attitude. You guys rock! And God Bless for all the good that you do …

PA Who had the biggest impact on how you carry yourself both personally and professionally? JP My father, Joe DiMaggio and of course, Frank Sinatra.

PA Tell us something that no one might know

PA What do you think you’d be doing if you weren’t entertaining? JP A singing doctor.

PA We’ve got a Super Bowl coming to Jersey in

PA What was your first job? JP Garbage man down the Shore.

PA What’s your favorite landmark in New Jersey? JP The oil refineries at Exit 13A. PA What’s the best thing to ever come out of New JP

Jersey? Attitude.

PA In your mind, what separates New Jersey from the JP

rest of the states in the Union? Its citizens. Independent, hard working and no pretense.

PA Any hobbies? JP Looking for the television remote at my house. PA Is there a philosophy or quote that you live by or try JP

to model your behavior after? If so, please elaborate. As Ed Norton said, ‘Be nice to the people you meet on the way up, cause you’re gonna meet the same people on the way down.’

PA What are you reading right now?

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JP

JP

about you? I like Spanish television. 2014…Out of the two New Jersey football teams, which one are you a fan of: New York Jets or New York Giants? Big Blue!

PA Favorite beach in New Jersey? JP LBI. PA Is there any charity (locally or nationally) that is JP

near and dear to your heart? Boys and Girls Clubs of NJ and Unity Community in Camden.

PA Who is tops? Frank Sinatra, Bruce Springsteen, JP

Bon Jovi or other? Uncle Floyd.

PA Favorite movie? JP Broadway Danny Rose.

PA In your honest opinion, “What exit?” JP 63 (GSP Exit for Rt. 72 East Manahawkin/LBI) PA If our docs (or anyone else) wants to comes see you perform, where can we find you? JP joepiscopo.com and Facebook! Or singing with surgeons in Princeton.


Past President, Raj Gupta, MD recently climbed Mt. Everest and represented the Medical Society of New Jersey very well during his trek.

Photos courtesy of Raj Gupta, MD

us your photos and d en S ! u yo re u at fe We want to trips in the U.S. and e ic rv se t n ce re r u yo stories from photo@msnj.org abroad. E-mail us at

“Global resources for NJ’s insurance needs”

For more information visit: www.msnjia.com or call 866-963-0698 19


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MSNJ encourages you to contact allRisk for all your emergency response, restoration and facility repair needs. MSNJ members receive VIP treatment 24 hrs a day. allRisk specializes in responding to fire, water, mold and structural damage in the highly regulated healthcare environment. If you plan to do business with your patients, put allRisk in your business plans. To protect your practice 24 hours a day from costly business interruption caused by fire, water or mold, store allRisk's VIP service line in your phone today: 877.247.5252.

877.247.5252 | www.TeamAllRisk.com

Summer 2010  

Volume 6, Issue 2

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